Dr. Ira Byock
As Fellow of the American Academy of Hospice and Palliative Medicine, Byock’s influence became a clarion call for well-being through the end of life.
Ira Byock,M.D., FAAHPM is an author and Founder & Chief Medical Officer at the Institute for Human Caring of Providence St. Joseph Health.
DM: What brought you to the world of palliative care?
I distinctly remember an encounter I had as an intern with a man who knew he was dying. Kneeling beside his bedside, I asked how he was doing, to which he replied, “I’m well doctor, how are you?” I thought oh, it’s the morphine or the steroids. This guy had a lot of tumors, and steroids can make you a little euphoric. But even so, I was taken aback by what he said. After practicing awhile and hearing other terminal patients say they too were “well” I became completely obsessed with the notion that perhaps, the subjective sense of well-being is possible even when you know you’re dying. Look, I was trained to be a family doctor, and the idea of well-being when we’re dying…well, that kind of transforms not only the arc of human development, but also all of the family systems stuff I was immersed in.
It got under my skin in so many ways— it led me to think about eastern wisdom and western language, and how we might reframe this time of life to include well-being. Then not two years later, my Dad became ill. His story became the first chapter of Dying Well. The whole experience of his dying clarified for me that illness is only partially medical. I have the technical and medical knowledge to be in service of the experience, but the experience is theirs, and it is personal.
DM: What is one lesson you’d like readers to take away from your book?
That’s an easy one! Human development is a lifelong process. And well-being is possible through the very end of life.
DM: What is your idea of perfect happiness?
Fly fishing in Montana. It’s heaven. You know if heaven doesn’t include fly fishing in Montana, well then, I’ll stay here.
DM: What is your current state of mind?
Excitedly content. There’s this quote from E.B. White which I’ve had above my desk for a very long time. He wrote, “If the world were merely seductive, that would be easy. If it were merely challenging, that would be no problem. But I arise in the morning torn between a desire to improve the world and a desire to enjoy the world. This makes it hard to plan the day.” This really resonates with my own experiences.
DM: Who are your favorite writers?
I read a lot of essays and Op-eds— anything by Frank Rich, Maureen Dowd, Rachel Mead, Calvin Trillin. In the realm of fiction my favorites are Herman Hesse, Kurt Vonnegut, Don DeLillo and Phillip Roth.
DM: What are you reading, what’s on your bedside table?
Two poetry collections— both of which I’ve gifted to the entire staff for the holidays. The first is called The Poetry of Impermanence, Mindfulness, and Joy. It’s edited by John Brehm, a poet from Oregon. It’s a fabulous book of poems from across the world and through history. Really wonderful. The second I read in galley form and actually wrote an endorsement for it. It’s called Salve by physician poet, Monisha Vasa. The book is transcendent, remarkable. Reminds me a lot of Rilke or Rumi’s poems, just phenomenal.
DM: What is one thing about you that would surprise people?
You know, I only have one truth, which makes me kind of an open book...I have a website, I write articles, I give lectures and I listen to the Grateful Dead on satellite radio. I love love love music…listen to music all the time, both classical and contemporary. However, I can’t play a note. Have tried and failed multiple times to play various instruments, but totally incapable. And you know, I’m at peace with that [laugh].
DM: What book would you like to be buried with?
I plan on being cremated, and I don’t burn books.
DM: What is your exit plan? How would you like to die?
I don’t know that plan! I’ve done an advanced directive and spoken with people. They basically know what I’d want regarding various circumstances and treatments. But part of living fully and dying well is recognizing that you’re going to need to let go of control. There’s no way for you to know exactly what circumstances you’ll be in, and that’s part of the wisdom of being at this stage of life. So, I am actively cultivating comfort in trusting others. That said, you know I’d like to die after some short illness, where I’m comfortable physically, surrounded by those I love, and those who love me, and drift from life gently.
DM: If you were to die and come back as a person or a thing, what would it be?
A lead guitarist for a rock n’ roll band.
DM: If heaven exists, what would you like to hear when you arrive at the Pearly Gates?
A chorus of familiar voices saying, “welcome, we’re so glad you’re here.”